Staged HIV transmission and treatment in a dynamic model with long-term partnerships (Q6038675)

In this paper, the authors developed a model for HIV transmission, taking account for the possibilities of an infection from either a casual sexual partner or a long-term partner who was either infected at the start of the partnership or has been newly infected since the onset of the partnership. One of the main novelties is that the impact of long-term partnerships is described by calculating the expected values of the rate of infection from these extended contacts. Three stages of infectiousness are considered in the model, namely acute, chronic, and virally suppressed. The authors calculated HIV incidence is calculated and the fraction of new infections attributed to casual contacts and long-term partnerships allowing for variability in protection, the effect of achieving and maintaining viral suppression, and early intervention. The model is applied to data concerning MSM HIV transmission from the CDC in the U.S. to find that although the acute stage is the most infectious, the majority of the new infections will be transmitted by long-term partners in the chronic stage. The authors perform time series analysis of the solution, as well as parameter sensitivity analysis to assess effectiveness intervention strategies.